Every year on October 10, the whole world celebrates Mental Health Day. People suffering from mental illness are vulnerable segments of the population, and their rights require special protection and guarantees from the state.

This is mainly due to the fact that such people are in places of captivity, that is, special medical and geriatric institutions, access to which is extremely limited.

This gives rise to risks of violation of the rights and freedoms of patients and wards of these institutions, which are very often quite latent for society. The lack of legal capacity does not allow to effectively counteract such violations, and the person, in fact, is left alone with his problems.

Over time, for such patients, torture, humiliating treatment, physical abuse become commonplace things that they perceive as the norm of their lives.

In developed countries, this problem is effectively solved with the help of national preventive mechanisms, which are already functioning in Ukraine today.

The rights of mentally ill people are protected by civil society, which independently monitors places of detention, identifies and documents violations.

There is nothing of the kind in the occupied Crimea, so the question arises of what the psychiatry of the occupied Crimea looks like today.

The situation was investigated by the analysts of Association of Reintegration of Crimea

The argument that necessitated such an analysis was the information about the revival in Russia of punitive psychiatry, inherent in the former USSR. This is really worrisome, because there are many persons with mental illness left on the occupied peninsula.

It is not known whether they receive quality mental health care and support. Of course, the fake “authorities” of the occupied Crimea are talking about “improving the quality of psychiatric care on the peninsula”. Similar statements are also heard from the “hospital management” controlled by the invaders.

In particular, Sergei Ryshtakov, so-called “head of the somatopsychiatric department of the Crimean Republican Psychiatric Hospital No. 1,” controlled by the aggressor, in an interview noted the improvement in the quality of services and the emergence of new drugs that “although expensive, but available” [1].

Despite such rosy statements, the situation with “psychiatry from the aggressor” is critical. Even the Russian media publish materials about the revival of punitive psychiatry, which is becoming a tool in the fight against “active citizens”. Also, the practice of forced detention in a psychiatric hospital in Russia is used by law enforcement officers to “establish a dialogue” with detainees.

All this is accompanied by violence, abuse, torture and inhuman treatment. In addition, throughout Russia, doctors violate the rights of mentally ill patients, in particular, they prescribe drugs that essentially make a person profoundly disabled [2]. It is easier for the Russian authorities to recognize a person as “dangerous” and restrict his freedom, although today in Europe and the world approaches to the treatment of such patients are changing dramatically.

Even some specialists from Russia dare to talk about the need to reform psychiatry in the state. In particular, they point to outdated approaches, the lack of an independent service to protect the rights of patients, on inadequate qualifications of medical personnel and psychiatrists, on inadequate funding, and on the absence of targeted programs for the prevention of mental disorders [3].

All these problems were felt by the Crimean residents, because, as you know, Russia not only occupied Crimea, but also brought its own model of the “Russian world” to the Ukrainian peninsula, where psychiatry is seen as an instrument of political influence [4]. That is, the problem is connected with two aspects: violation of the rights of mentally ill patients and hospitalization in psychiatric institutions of people disadvantageous to the “authorities”.

Let’s start with the second problem.

After the occupation of Crimea, the number of placements in “psychiatric hospitals” of Crimean residents, who have a pro-Ukrainian position and are not ready to endure the occupation regime, has increased significantly. So, in 2020, the invaders arrested Crimean resident Alexander Sizikov, who is disabled because he lost his sight in a car accident.

In 2015, he opposed the arrests of Muslims with a picket, but the FSB accused him of allegedly “supporting the Islamic Liberation Party” terrorist organization. Alexander was placed in a “psychiatric hospital” for a month, allegedly for “passing a forensic psychiatric examination”. Despite the fact that Alexander does not have mental disorders and could undergo this examination on an outpatient basis, he was forced to spend a month “in a hospital”, without access to lawyers and family members [5].

The occupational “authority” chose a similar tactic of recognizing “crazy” for the deputy chairman of the Mejlis of the Crimean Tatar People, Nariman Dzhelyalov, who, as part of an unlawful “criminal case”, was placed in a “psychiatric hospital” without any reason.

According to Nariman’s relatives, the conditions there are very bad, patients are constantly bullied, they do not give access to the phone and restrict the right to walk. Under such conditions, a person becomes depressed and loses all freedom [6]. According to a similar scenario, Servet Mustafayev ended up in a “psychiatric hospital”, whom the invaders also accused of “terrorism”. According to him, being in a “psychiatric hospital” is simply a form of torture, since it is difficult for a healthy person to endure the neighborhood with mentally ill people who can show aggression at any time [7].

It is obvious that the Russian punishers of the occupied Crimea are using “psychiatric expertise” not for its intended purpose, that is, their main goal is not to examine, but to break a person and force him to be submissive. This assumption is proved by the testimony of Ilmi Umerov, who was also placed in a “psychiatric hospital” in Crimea forcibly and kept there for three weeks. Moreover, the “examination” itself lasted several hours only, and consisted of short conversations with doctors [8].

However, there are more egregious cases when a person was “court-sentenced” to “compulsory treatment” in a “psychiatric hospital”. We are talking about the Yalta activist Yunus Masharipov, whom the FSB accused of allegedly “arson of forests” and “preparation of terrorist attacks”. Having gone through all the possible invaders’ “judicial instances”, Masharipov was “recognized as incompetent” and was unlawfully placed “indefinitely in a closed mental hospital” [9].

In addition, there is a problem of violation of the patients’ rights in psychiatric institutions in the occupied peninsula. And here we should start with recent events. In particular, in 2020, against the background of the covid pandemic, an outbreak of the disease was discovered in the above-mentioned “Crimean Republican Psychiatric Hospital”. Moreover, this happened because doctors taking patients to the “hospital” did not even ask them to provide a negative text for the code. There was also the negligence of the “hospital” staff, who did not even isolate patients with fever from other hospitalized [10]. This has become a direct violation of the rights of mentally ill patients, since they simply cannot claim their rights and complain about the inaction of the “hospital” staff. However, these are just “flowers”, compared to other facts.

In 2019, a patient died of serious bodily injuries in the same “hospital”. According to the “management” of the institution, the men were allegedly “simply beaten”, and no details were given to the society. The Russian invaders’ “punishers” also very briefly informed about the incident, noting that “the patient died from his injuries” [11].

It is rather strange when a person dies from a beating in a “closed medical institution”, where there is an appropriate “regime and staff”. It can be assumed that these bodily injuries were caused precisely by the personnel of the “hospital” for “non-compliance with the regime”. A similar incident occurred in the Simferopol “psychiatric hospital” in 2021, when a 39-year-old patient was beaten to death by an orderly [12].

By the way, in the same hospital in 2018 it was impossible to hide “violation of the rules for storing medicines, violation of sanitary conditions in the hospital and inadequate nutrition of patients” [13]. And this is natural, because if there is no one to protect the rights of mentally ill patients, then a large number of people who want to violate them appear.

Corruption in the “psychiatric care system” of the occupied Crimea also emerges from time to time. So, back in 2015, in Simferopol, the “management of the Republican Clinical Psychiatric Hospital No. 5” controlled by the invaders submitted a “tender application” for the purchase of 6.5 tons of fresh-frozen fish worth about one and a half million rubles. Experts considered that on this transaction alone, the “chief physician” Alexander Soldatenko pocketed half a million rubles [14].

This is not the only case of corruption, since in 2016 the theft of almost a million rubles “surfaced” under the pretext of “overhauling the Sevastopol City Psychiatric Hospital”; collaborators from “administration” appropriated this money together with the “contractor firm” “Monitoring, Design, Construction”[15].

We should also mention the land plots on the resort peninsula, which are very attractive to the Russian invaders’ “authorities”. In particular, in 2016, the occupiers “made a decision” to close the psychiatric hospital in the Leninsky district. According to Crimean residents, the hospital was in demand, but the occupiers first artificially created problems with the financing of the institution, and subsequently “decided to close” [16].

As a result of such “optimization”, truly mentally ill patients who can be dangerous to others, unlike the political prisoners of the Kremlin, are released. And this is a real threat, because such persons can cause a gas explosion in an apartment building, a fire, or simply cause bodily harm to others.

But the occupying “authorities”, of course, do not pay attention to the problems of ordinary Crimean residents. Already in January 2022, a tragedy occurred, which became a vivid example of the fact that psychiatry in the occupied peninsula is in a terrible state. In the village of Novy Svet near Sudak, a mother threw her eight-year-old daughter out of a window. The woman was “registered in a psychiatric hospital”, and recently she did not receive the necessary medicines. Therefore, she was forced to buy ineffective “Russian drugs” on her own, but they did not bring the desired result. Doctors justified themselves by saying that the woman allegedly “began to drink alcohol, and this reduced the effect of treatment” [17].

The occupiers are trying to mask the negligence of the “psychiatric care system” with all sorts of pseudo-initiators, which cause indignation among the Crimean residents. For example, last year Crimean psychiatrists announced that they would vigorously “check hunters who want to get a weapon permit” because “psychiatrists must understand the motivation of a potential killer of animals” [18]. A very interesting approach, to release the mentally ill with freedom and not supply them with the necessary drugs, and at the same time worry about the “motivation of the hunters”.

It rather resembles an attempt to create a new source of corruption benefits. And we would also like to ask if the Crimean psychiatrists want to check the motivation of high-ranking officials from the Kremlin, who ordered the occupation of the Ukrainian peninsula and allowed the militants to kill Ukrainians in the Donbass, and then launched a large-scale aggression against Ukraine.

It is assumed that the occupiers violated not only the fundamental rights of mentally ill patients, but they also manipulate with their “political freedoms”. In particular, in 2020, the Russian invaders forced the patients of “psychiatric hospitals” in the occupied Crimea to participate in the “referendum”. Moreover, the staff of medical institutions held “explanatory conversations” with patients so that they “supported the amendments to the Russian constitution”.

Later, the fake “election commissions” of the occupiers denied this, but many witnesses remained, in particular Crimean political prisoners, who at that time were in various “psychiatric hospitals” undergoing a fake “forensic psychiatric examination” [19]. That is, for the Kremlin, the mentally ill residents of the peninsula are a “valuable electorate” who can be forced to “support” the “solutions” necessary for Russia.

There are cases when the psychiatry of the occupied Crimea works by order. In particular, in 2019, the peninsula was stirred up by a story about a 25-year-old girl who was forcibly placed in a “psychiatric hospital for treatment.” The reason was the request of the mother, who tritely wanted to “issue a disability for her daughter” and receive her “pension”.

Most likely, the mother gave a bribe to the “psychiatrist” and representatives of the occupiers’ “police” who worked very quickly. At the same time, as eyewitnesses reported, the girl was absolutely healthy and did not pose a threat to society. According to the girl, she was insulted, driven to hysterics, and then psychotropic drugs were injected without her permission. When acquaintances tried to fire her, the “hospital” appealed to the occupiers’ “court”, which issued a “decision on compulsory treatment” [20]. Unfortunately, in this situation, no one can effectively protect the rights of a citizen. We can only publish this information and document the facts of offenses.

According to the World Psychiatric Association’s Regulations and Views on the Rights and Legal Protection of Mentally Ill Patients since 1989, patients have the right to: adequate provision of medications, a guardian or qualified lawyer, communication with family members, appropriate living conditions, information about tactics and methods of treatment and etc.

Even the aggressor’s outdated law “On psychiatric care and guarantees of the rights of citizens in its provision” in 1992 refers to a humane and respectful attitude towards such persons, as well as guaranteeing other rights provided for by the constitution [22], but the Russian invaders do not comply with the relevant human rights either at their home or in the occupied Crimea.

According to the results of the assessment and recommendations for integrating mental health into primary health care and community platforms in Ukraine, external aggression has had a negative impact on the mental health of Ukrainians, including those remaining on the occupied peninsula.

Experts emphasize that an urgent problem is the lack of effective mechanisms for protecting the rights of mentally ill patients, as well as the lack of advocacy campaigns regarding the legal protection of such categories of citizens [23]. Of course, it is not possible to talk about the prospects for the development of the human rights movement in the occupied Crimea. Therefore, patients and their family members are forced to deal with violations of their rights on their own.

Consequently, the psychiatry of the occupied Crimea has nothing to do with the image that Russian propaganda creates. There is no need to talk about any high standards of services and respect for patients. The reality is much worse: after the occupation, psychiatry in Crimea became an instrument of political struggle against opponents of the Kremlin regime, and for persons with mental disorders it became a challenge, as they are forced to search for high-quality drugs on their own and spend years in the inhuman conditions of the Crimean “psychiatric hospitals”.

Of course, the large-scale Russian aggression against Ukraine did not “improve” the situation of the Crimean psychiatry in any way. Moreover, there are psychiatric institutions in the Russia-occupied territories of the southern mainland of Ukraine, the events in which since March 2022 can only be guessed at. In particular, the situation of patients and staff of the Kherson Regional Psychiatric Hospital, located in the Russian-occupied village of Stepanovka near the regional center, is unknown.

It should be noted that the risks for mental health, for patients and staff of Ukrainian hospitals were recognized by the World Health Organization, adopting on May 26, 2022 at its Seventy-fifth session the resolution “ Health emergency in Ukraine and refugee receiving and hosting countries, stemming from the Russian Federation’s aggression ” and establishing a special mechanism for international monitoring of the situation [24].

Sources:

1. https://vesti-k.ru/

2. https://lenta.ru/

3. https://www.kommersant.ru/

4. https://www.hse.ru/

5. https://life.pravda.com.ua/society/2020/11/19/243062/

6. https://crimea.suspilne.media/ru/articles/137

7. https://ru.krymr.com/a/psihiatricheskaya-ekspertiza-v-krymu-kak-element -repressiy/29660542.html

8. https://zmina.info/news/umerov_pro_psihiatrichnu_likarnju_ce_bulo_sucilne_katuvannja-2/

9. https://zmina.info/articles/zayavyl-o-p%D1%8Btkah-okazalsya-v-psyhlechebnycze-kak-v-kr%D1%8Bmu-prymenyayut-karatelnuyu-psyhyatryyu/

10. https://regnum.ru/

11. https://forpostsevastopol.ru/

12. https://crimea-news.com/

13. https://www.3652.ru/news/

14. https://fedpress.ru/news/econom/budget

15. https://sevastopol.bezformata.com/

16. https://newdaynews.ru/

17. https://flot2017.com/nedetskaya-tragediya-okkupanty-v-krymu-lishili-psihiatricheskoj-pomoshhi-mat-detoubijcu/

18. https://news.allcrimea.net/

19. https://graty.me/news/v-simferopolskom-sizo-i-psihiatricheskoj-klinike-zaklyuchennyh-krymskih-tatar-prinuzhdayut-golosovat-na-referendume-po-popravkam-v-konstitucziyu-rf/

20. https://blogs.korrespondent.net/blog/

21. https://zakon.rada.gov.ua/laws/show/995_871#Text

22. http://www.consultant.ru/

23. http://ipz.org.ua/wp-content/uploads/2018/01/MH-report-for_INTERNET_All_ua.pdf

24. https://arc.construction/32003